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Impact of metabolic dysfunction-associated steatotic liver.disease on COVID-19 hospitalizations:A pr.pensity-matched analysis of the United States

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Wor.d Jour.al of Vir.logy 2024年第1期13卷 51-60页

作者： Abdullah Sohail Hassam Ali Pr.tik patel Subanandhini Subr.manium Dushyant Singh Dahiya Amir.H Sohail manesh Kumar.Gangwani Sanjaya K Satapathy Depar.ment of Inter.al Medicine University of Iowa Roy J and Lucille A Carver College of MedicineIowaIA 52242United States Division of Gastr.enter.logy and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Depar.ment of Gastr.enter.logy Mather Hospital/Hofstra University Zucker School of MedicineNY11777United States Depar.ment of Inter.al Medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States Division of Gastr.enter.logy Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Depar.ment of Sur.er. University of New MexicoAlbuquerqueNM 87106United States Depar.ment of Inter.al Medicine The University of ToledoToledoOH 43606United States Section on Gastr.enter.logy and Hepatology North Shore University Hospital and Long Island Jewish Medical CenterManhassetNY 11030United States

BACKGr.UND Metabolic dysfunction-associated steatotic liver.disease(MASLD),for.ally known as nonalcoholic fatty liver.disease,is the most common chr.nic liver.disease in the United *** with MASLD have been r.por.ed to be at a higher.r.sk of developing sever. cor.navir.s disease 2019(COVID-19)and ***,most studies ar. single-center.studies,and nationwide data in the AIM To study the influence of MASLD on COVID-19 hospitalizations dur.ng the initial phase of the *** We r.tr.spectively analyzed the 2020 National Inpatient Sample(NIS)database to identify pr.mar. COVID-19 hospitalizations based on an under.ying diagnosis of MASLD.A matched compar.son cohor. of COVID-19 hospit-alizations without MASLD was identified fr.m NIS after.1:N pr.pensity scor. matching based on gender.r.ce,and comor.idities,including hyper.ension,hear. failur.,diabetes,and *** pr.mar. outcomes included inpatient mor.ality,length of stay,and hospitalization *** outcomes included the pr.valence of systemic *** A total of 2210 hospitalizations with MASLD wer. matched to 2210 hospitalizations without MASLD,with a good comor.idity ***,ther. was a higher.pr.valence of sever. disease with mor. intensive car. unit admissions(9.5%vs 7.2%,P=0.007),mechanical ventilation(7.2%vs 5.7%,P=0.03),and septic shock(5.2%vs 2.7%,Pr. than in the non-MASLD ***,ther. was no differ.nce in mor.ality(8.6%vs 10%,P=0.49),length of stay(5 d vs 5 d,P=0.25),and hospitalization costs(42081.5$vs 38614$,P=0.15)between the MASLD and non-MASLD *** The pr.sence of MAFLD with or.without liver.cir.hosis was not associated with incr.ased mor.ality in COVID-19 hospitalizations;however.ther. was an incr.ased incidence of sever. COVID-19 *** data(2020)pr.dates the availability of COVID-19 vaccines,and many MASLD patients have since been *** will be inter.sting to see if these tr.nds ar.

关键词： COVID-19 Metabolic dysfunction-associated steatotic liver.disease Pr.valence Hospital char.es Inpatient r.sour.e utilization

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Global tr.nds in hepatitis C-r.lated hepatocellular.car.inoma mor.ality:A public database analysis(1999-2019)

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Wor.d Jour.al of Vir.logy 2024年第1期13卷 69-83页

作者： Hassam Ali Fnu Vikash Vishali Moond Fatima Khalid Abdur.r.hman Jamil Dushyant Singh Dahiya Amir.Humza Sohail manesh Kumar.Gangwani Pr.tik patel Sanjaya K Satapathy Depar.ment of Inter.al Medicine/Gastr.enter.logy East Carolina University Brody School of MedicineGreenvilleNC 27834United States Depar.ment of Inter.al Medicine Jacobi Medical Center/Albert Einstein College of MedicineBronxNY 10461United States Depar.ment of Inter.al Medicine Saint Peter's University Hospital/Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States Depar.ment of Inter.al Medicine Quaid-e-Azam Medical CollegeBahawalpur 63100PunjabPakistan Depar.ment of Inter.al Medicine Samaritan Medical CentreWatertownMA 13601United States Division of Gastr.enter.logy Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Depar.ment of Sur.er. New York University Winthrop HospitalNew YorkMineloaNY 11501United States Depar.ment of Inter.al Medicine The University of ToledoToledoOH 43606United States Depar.ment of Gastr.enter.logy Mather Hospital/Hofstra University Zucker School of MedicineNY 11777United States Division of Hepatology Department of MedicineNorth Shore University HospitalManhassetNY 11030United States

BACKGr.UND Hepatitis C is the leading cause of chr.nic liver.disease wor.dwide and it significantly contr.butes to the bur.en of hepatocellular.car.inoma(HCC).However.ther. ar. mar.ed var.ations in the incidence and mor.ality r.tes of HCC acr.ss differ.nt geogr.phical *** the advent of new widely available tr.atment modalities,such as dir.ct-acting antivir.ls,it is becoming incr.asingly imper.tive to under.tand the tempor.l and geogr.phical tr.nds in HCC mor.ality associated with Hepatitis ***,gender.dispar.ties in HCC mor.ality r.lated to Hepatitis C ar. a cr.cial,yet under.xplor.d aspect that adds to the disease's global *** some studies shed light on gender.specific tr.nds,ther. is a lack of compr.hensive data on global and r.gional mor.ality r.tes,par.icular.y those highlighting gender.*** gap in knowledge hinder. the development of tar.eted inter.entions and r.sour.e allocation *** The r.sults of our.study show an over.ll decline in the mor.ality r.tes of patients with hepatitis C-r.lated HCC over.the last two ***,females exhibited a r.mar.able decr.ase in mor.ality compar.d to ***,East Asia and the Pacific displayed a significant decline in mor.ality,while Eur.pe and Centr.l Asia witnessed an upwar. *** Amer.ca and the Car.bbean also exper.enced an incr.ase in mor.ality ***,no significant differ.nce was obser.ed in the Middle East and Nor.h *** Amer.ca exhibited a notable upwar. *** Asia and Sub-Sahar.n Afr.ca significantly declined thr.ughout the study *** r.ises the hope of identifying ar.as for.implementing mor. tar.eted *** some pr.gr.ss,multiple challenges r.main in meeting the WHO 2030 goal of eliminating vir.l hepatitis[24].

关键词： Car.inoma Hepatocellular Antivir.l agents Global Bur.en of Disease Quality indicator. Health car. Liver.neoplasms Hepatitis C Chr.nic hepatitis C

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r.le of fecal micr.biota tr.nsplant in management of hepatic encephalopathy: Cur.ent tr.nds and futur. dir.ctions

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Wor.d Jour.al of Hepatology 2024年第1期16卷 17-32页

作者： Yash r.Shah Hassam Ali Angad Tiwar. David Guevar.-Lazo Natalia Nomber.-Aznar.n Bhanu Siva Mohan Pinnam manesh Kumar.Gangwani Har.shankar.Gopakumar.Amir.H Sohail Sr.LakshmiDevi Kanumilli Er.esto Calder.n-Mar.inez Geetha Kr.shnamoor.hy Nimish Thakr.l Dushyant Singh Dahiya Depar.ment of Inter.al Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastr.enter.logy and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Depar.ment of Inter.al Medicine Maharani Laxmi Bai Medical CollegeJhansi 284001India Faculty of Medicine Universidad Peruana Cayetano HerediaLima 15102Peru Depar.ment of Inter.al Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Depar.ment of Inter.al Medicine The University of ToledoToledoOH 43606United States Depar.ment of Gastr.enter.logy and Hepatology University of Illinois College of Medicine at PeoriaPeoriaIL 61605United States Depar.ment of Sur.er. University of New MexicoAlbuquerqueNM 87106United States Depar.ment of Inter.al Medicine GSL Medical CollegeRajamahendravaram 533296India Depar.ment of Inter.al Medicine Universidad Nacional Autonoma de MexicoCiudad De Mexico 04510Mexico Depar.ment of Digestive Diseases and Nutr.tion University of KentuckyLexingtonKY 40536United States Division of Gastr.enter.logy Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States

Fecal micr.biota tr.nsplantation(FMT)offer. a potential tr.atment avenue for.hepatic encephalopathy(HE)by lever.ging beneficial bacter.al displacement to r.stor. a balanced gut *** pr.valence of HE var.es with liver.disease sever.ty and *** pathogenesis involves ammonia toxicity,gut-br.in communication disr.ption,and *** aims to r.stor. gut micr.biota balance,addr.ssing these ***'s efficacy has been explor.d in var.ous conditions,including *** suggest that FMT can modulate gut micr.biota,r.duce ammonia levels,and alleviate *** has shown pr.mise in alcohol-associated,hepatitis B and C-associated,and non-alcoholic fatty liver.*** include impr.ved liver.function,cognitive function,and the slowing of disease ***,lar.er.contr.lled studies ar. needed to validate its effectiveness in these *** have shown cognitive impr.vements thr.ugh FMT,with potential benefits in cir.hotic ***,tr.als have demonstr.ted r.duced ser.ous adver.e events and cognitive enhancements in FMT ar.s compar.d to the standar. of *** evidence is pr.mising,challenges r.main:Limited patient number.,var.ed dosages,administr.tion r.utes,and donor.*** lar.e-scale,contr.lled tr.als ar. essential to establish standar.ized guidelines and ensur. FMT's clinical applications and *** FMT holds potential for.HE management,ongoing r.sear.h is needed to addr.ss these challenges,optimize pr.tocols,and expand its availability as a ther.peutic option for.diver.e hepatic conditions.

关键词： Hepatic encephalopathy Fecal micr.biota tr.nsplant Cognitive impair.ent Liver.cir.hosis Chr.nic liver.disease

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The assessment of atr.al function by velocity-encoded magnetic r.sonance imaging

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Wor.d Jour.al of Car.iovascular.Diseases 2013年第2期3卷 18-24页

作者： Char.es C. Vu John F. Heitner.Igor.Klem Peter.J. Cawley Anna Lisa C. Cr.wley manesh r. patel Jonathan W. Weinsaft Michele A. Par.er.Michael Elliott r.ber. M. Judd r.ymond J. Kim Joseph C. Gr.enfield Jr. Division of Car.iology New York Methodist Hospital Brooklyn USA Division of Car.iology New York Presbyterian Hospital Weill Cornell Medical Center New York USA Division of Car.iology University of Washington School of Medicine Seattle USA Duke Car.iovascular.Magnetic r.sonance Center Duke University Medical Center Durham USA Stony Br.ok School of Medicine Stony Brook USA

Intr.duction: The pur.ose of this study was to assess velocity-encoded car.iac magnetic r.sonance imaging (Ve-CMr. in a population of patients r.fer.ed for.car.iac magnetic r.sonance imaging (CMr., to deter.ine the var.ability of atr.al function, and to identify clinical par.meter. associated with left atr.al function. Methods: This is a pr.spective study evaluating patients who wer. r.fer.ed to our.CMr.center.for.a clinical CMr. Left atr.al function was obtained via Ve-CMr.thr.-plane images acr.ss the mitr.l valve after.acquir.ng 2 per.endicular.in-plane images as “scouts”. The atr.al function and mitr.l inflow wer. quantified by computer.analysis (Ar.us, Siemens). Atr.al function was defined as atr.al contr.ction (A-wave) volume divided by total inflow volume. Left atr.al volumes wer. calculated via computer.analysis. Mitr.l r.gur.itation and left ventr.cular.ejection fr.ctions wer. assessed visually. r.sults: Thir.y-nine patients, with mean age 56 +/- 10 year., wer. enr.lled. The mean left atr.al function was 22.9% +/-14.5%;the r.nge in left atr.al function was 0% - 57%. Ther. was a significant positive cor.elation between atr.al function and incr.ased left ventr.cular.ejection fr.ction (r.= 0.44, P r. was a significant negative cor.elation between atr.al function and sever.ty of mitr.l r.gur.itation (r.= -0.60, P r.al volume (r.= -0.36, P = 0.02). Conclusion: Our.r.sults indicate a wide var.ability in left atr.al function and a significant association between left atr.al function and left ventr.cular.ejection fr.ction, left atr.al volume and mitr.l r.gur.itation.

关键词： Atr.al Function Velocity-Encoded Car.iovascular Magnetic r.sonance

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Impact of fr.ilty on endoscopic r.tr.gr.de cholangiopancr.atogr.phy outcomes in nonagenar.ans:A United States national exper.ence

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Wor.d Jour.al of Gastr.intestinal Endoscopy 2024年第3期16卷 148-156页

作者： Sanket Dhir.bhai Basida Dushyant Singh Dahiya Muhammad Nadeem Yousaf Br.nda Basida Bhanu Siva Mohan Pinnam manesh Kumar.Gangwani Hassam Ali Sahib Singh Yash r.Shah Daksh Ahluwalia Mihir.Pr.kash Shah Saur.bh Chandan Neil r.Shar.a Shyam Thakkar Depar.ment of Inter.al Medicine University of Missouri-ColumbiaColumbiaMO 65212United States Division of Gastr.enter.logy Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Division of Gastr.enter.logy and Hepatology University of MissouriColumbiaMO 65212United States Depar.ment of r.eumatology Medical College of GeorgiaAugusta UniversityNorth AugustaGA 30912United States Depar.ment of Inter.al Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Depar.ment of Inter.al Medicine The University of ToledoToledoOH 43606United States Division of Gastr.enter.logy and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Depar.ment of Inter.al Medicine Sinai HospitalBaltimoreMD 21215United States Depar.ment of Inter.al Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastr.enter.logy and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Inter.entional Oncology&Sur.ical Endoscopy GI Oncology Tumor Site TeamParkview Cancer InstituteParkview HealthFort WayneIN 46845United States Section of Gastr.enter.logy&Hepatology West Virginia University School of MedicineMorgantownWV 26505United States

BACKGr.UND Endoscopic r.tr.gr.de cholangiopancr.atogr.phy(Er.P)is an essential ther.peutic tool for.biliar. and pancr.atic *** and elder.y patients,especially those aged≥90 year. ar. gener.lly consider.d a higher.r.sk population for.Er.P-r.lated *** To investigate outcomes of Er.P in the Non-agenar.an population(≥90 year.)concer.ing *** This is a cohor. study using the 2018-2020 National r.admission *** aged≥90 wer. identified who under.ent Er.P,using the inter.ational classification of diseases-10 code with clinical *** Hopkins’s adjusted clinical gr.ups fr.ilty indicator.was used to classify patients as fr.il and *** pr.mar. outcome was mor.ality,and the secondar. outcomes wer. mor.idity and the 30 d r.admission r.te r.lated to *** used univar.ate and multivar.ate r.gr.ssion models for.*** A total of 9448 patients wer. admitted for.any indications of *** and non-fr.il patients wer. 3445(36.46%)and 6003(63.53%)*** for.Er.P wer. Choledocholithiasis(74.84%),Biliar. pancr.atitis(9.19%),Pancr.atico-biliar. cancer.7.6%),Biliar. str.ctur.(4.84%),and Cholangitis(1.51%).Mor.ality r.tes wer. higher.in fr.il gr.up[adjusted odds r.tio(aOr.=1.68,P=0.02].The Intr.-pr.cedur.l complications wer. insigni-ficant between the two gr.ups which included bleeding(aOr.0.72,P=0.67),accidental punctur.s/lacer.tions(aOr.0.77,P=0.5),and mechanical ventilation r.tes(aOr.1.19,P=0.6).Post-Er.P complication r.te was similar.for.bleeding(aOr.0.72,P=0.41)and post-Er.P pancr.atitis(aOr.1.4,P=0.44).Fr.il patients had a longer.length of stay(6.7 d vs 5.5 d)and higher.mean total char.es of hospitalization($78807 vs$71392)compar.d to contr.ls(Pr.admission r.tes between fr.il and non-fr.il patients wer. similar.P=0.96).CONCLUSION Ther. was a significantly higher.mor.ality r.sk and healthcar. bur.en amongst nonagenar.an fr.il patients under.oing Er.P compar.d

关键词： Endoscopic r.tr.gr.de cholangiopancr.atogr.phy Nonagenar.ans Fr.ilty Mor.ality Healthcar. bur.en

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r.mimazolam for.sedation in gastr.intestinal endoscopy:A compr.hensive r.view

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Wor.d Jour.al of Gastr.intestinal Endoscopy 2024年第7期16卷 385-395页

作者： Dushyant Singh Dahiya Ganesh Kumar.Syeda Par.a manesh Kumar.Gangwani Hassam Ali Amir.Humza Sohail Saqr.Alsakar.eh Umar.Hayat Sheza Malik Yash r.Shah Bhanu Siva Mohan Pinnam Sahib Singh Islam Mohamed Adishwar.r.o Saur.bh Chandan Mohammad Al-Haddad Division of Gastr.enter.logy Hepatology&MotilityThe University of Kansas School of MedicineKansas CityMO 66160United States Depar.ment of Inter.al Medicine Chandka Medical CollegeSindh 77280Pakistan Depar.ment of Gastr.enter.logy and Hepatology University of Arkansas For Medical SciencesLittle RockAR 72205United States Division of Gastr.enter.logy Hepatology and NutritionEast Carolina University/Brody School of MedicineGreenvilleNC 27858United States Depar.ment of Sur.er. University of New Mexico School of MedicineAlbuquerqueNM 87106United States Depar.ment of Inter.al Medicine University of Missouri-Kansas CityKansas CityMO 64108United States Depar.ment of Inter.al Medicine Geisinger Wyoming Valley Medical CenterWilkes BarrePA 18711United States Depar.ment of Inter.al Medicine Rochester General HospitalRochesterNY 14621United States Depar.ment of Inter.al Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Depar.ment of Inter.al Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Depar.ment of Inter.al Medicine Sinai hospitalBaltimoreMD 21215United States Depar.ment of Hepatology University of MissouriColumbiaMO 65211United States Depar.ment of Inter.al Medicine Guthrie Robert Packer HospitalSayrePA 18840United States Division of Gastr.enter.logy and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Gastr.enter.logy and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

Wor.dwide,a major.ty of r.utine endoscopic pr.cedur.s ar. per.or.ed under.some for. of sedation to maximize patient ***,benzodiazepines and opioids continue to be widely ***,in r.cent year.,r.mimazolam is gaining immense popular.ty for.pr.cedur.l sedation in gastr.intestinal(GI)*** is an ultr.-shor.-acting benzodiazepine sedative which was appr.ved by the Food and Dr.g Administr.tion in July 2020 for.use in pr.cedur.l *** has shown a favor.ble phar.acokinetic and phar.acodynamic pr.file in ter.s of its non-specific metabolism by tissue ester.se,volume of distr.bution,total body clear.nce,and negligible dr.g-dr.g *** also has satisfactor. efficacy and has achieved high r.tes of successful sedation in GI ***,studies have demonstr.ted that the efficacy of r.mimazolam is non-infer.or.to Pr.pofol,which is cur.ently a gold standar. for.pr.cedur.l sedation in most par.s of the ***,the use of Pr.pofol is associated with hemodynamic instability and r.spir.tor. *** contr.st,r.mimazolam has lower.incidence of these adver.e effects intr.-pr.cedur.lly and hence,may pr.vide a safer.alter.ative to Pr.pofol in pr.cedur.l *** this compr.hensive nar.ative r.view,highlight the phar.acologic char.cter.stics,efficacy,and safety of r.mimazolam for.pr.cedur.l *** also discuss the potential of r.mimazolam as a suitable alter.ative and how it can shape the futur. of pr.cedur.l sedation in gastr.enter.logy.

关键词： r.mimazolam Endoscopy Sedation Outcomes Efficacy Safety Phar.acokinetics

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Sepsis dur.ng shor. bowel syndr.me hospitalizations:Identifying tr.nds,dispar.ties,and clinical outcomes in the United States

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Wor.d Jour.al of Gastr.intestinal Pathophysiology 2024年第1期15卷 26-36页

作者： Dushyant Singh Dahiya Jennifer.Wachala Shantanu Solanki Dhanshr.e Solanki Asim Kichloo Samantha Holcomb Uvesh Mansur. Khwaja Saad Haq Hassam Ali manesh Kumar.Gangwani Yash r.Shah Ter.sa Var.hese Hafiz Muzaffar.Akbar.Khan Simon Peter.Hor.len Thomas D Schiano Syed-Mohammed Jafr. Division of Gastr.enter.logy Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Depar.ment of Inter.al Medicine Samaritan Medical CenterWatertownNY 13601United States Division of Gastr.enter.logy Hepatology&Nutr.tion The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Depar.ment of Medicine Institute for Foreign Medical Graduate EducationHoustonTX 77030United States Depar.ment of Inter.al Medicine MedStar Harbor HospitalBaltimoreMD 21225United States Depar.ment of Inter.al Medicine WellStar Spalding Regional HospitalGriffinGA 30224United States Division of Gastr.enter.logy Hepatology and NutritionEast Carolina University/Brody School of MedicineGreenvilleNC 27858United States Depar.ment of Gastr.enter.logy and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States Depar.ment of Inter.al Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastr.enter.logy and Hepatology SUNY Upstate Medical UniversitySyracuseNY 13210United States Depar.ment of Pediatr.cs School of Medicine and UPMC Children’s Hospital of PittsburghUniversity of PittsburghPittsburghPA 15219United States Division of Liver.Diseases Icahn School of Medicine at Mount SinaiNew YorkNY 10029United States Division of Gastr.enter.logy and Hepatology Henry Ford HospitalDetroitMI 48202United States

BACKGr.UND Shor. bowel syndr.me(SBS)hospitalizations ar. often complicated with *** is a significant paucity of data on adult SBS hospitalizations in the United States and acr.ss the *** To assess tr.nds and outcomes of SBS hospitalizations complicated by sepsis in the United *** The National Inpatient Sample was utilized to identify all adult SBS hospitalizations between *** study cohor. was fur.her.divided based on the pr.sence or.absence of *** wer. identified,and hospitalization char.cter.stics and clinical outcomes wer. *** of mor.ality for.SBS hospitalizations complicated with sepsis wer. *** Of 247097 SBS hospitalizations,21.7%wer. complicated by *** SBS hospitalizations had a r.sing tr.nd of hospitalizations fr.m 20.8%in 2005 to 23.5%in 2014(P tr.ndr.d to non-septic SBS hospitalizations,septic SBS hospitalizations had a higher.pr.por.ion of males(32.8%vs 29.3%,Pr.ups,and ethnic minor.ties,i.e.,Blacks(12.4%vs 11.3%,Pr.her.or.,septic SBS hospitalizations had a higher.pr.por.ion of patients with intestinal tr.nsplantation(0.33%vs 0.22%,Pr.ality(8.5%vs 1.4%,Pr.d to the non-sepsis cohor..A younger.age,female gender.White r.ce,and pr.sence of comor.idities such as anemia and depr.ssion wer. identified to be independent pr.dictor. of inpatient mor.ality for.septic SBS *** Septic SBS hospitalizations had a r.sing tr.nd between 2005-2014 and wer. associated with higher.inpatient mor.ality compar.d to non-septic SBS hospitalizations.

关键词： Shor. bowel syndr.me Sepsis Outcomes Mor.ality Tr.nds

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Or.anizational Changes Needed in Disaster. and Public Health Emer.encies:A Qualitative Study among Manager. at a Major.Hospital

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Inter.ational Jour.al of Disaster.r.sk Science 2022年第4期13卷 481-494页

作者： Ingela Wennman Cathar.na Jacobson Er.c Car.str.m Ander. Hyltander.Amir.Khor.am‑manesh Institute of Health and Car. Sciences Sahlgrenska AcademyGothenburg University41346GothenburgSweden Pr.par.dness Unit Sahlgrenska University Hospital41305 GothenburgSweden Institute of Clinical Sciences Department of SurgerySahlgrenska AcademyGothenburg University41345GothenburgSweden

Most hospitals have a contingency plan,based on all-r.sks and all-hazar.s assessment ***,emer.ing thr.ats and r.sks often necessitate a flexible appr.ach to emer.ency management at sever.l levels of a disaster.r.sponse system,for.example,in ***,and possibly other.countr.es,has limited possibilities of sur.e capacity in the management of lar.e-scale disaster. and emer.encies,which necessitates a local/national par.ner.hip and a flexible local disaster.and contingency *** study evaluates the opinions of a selected manager.al gr.up,both at oper.tive and str.tegic levels,r.gar.ing possible changes in a major.hospital's contingency plan dur.ng the ongoing COVID-19 *** inter.iews wer. conducted to explor. the elements of sur.e capacity and an oper.tional tool,consisting of command and contr.l,safety,communication,assessment,tr.age,tr.atment,and *** r.sults show a need to cr.ate feasible management methods that can be evaluated,establish clear.leader.hip,put pr.par.dness as a constant point on the highest manager.al agenda,impr.ve exter.al monitor.ng,and cr.ate a r.gional coor.inating ***,the r.sults emphasize the significant r.le played by the incident command system and qualified leader.hip to facilitate competent and cr.cial medical decision making,as well as to pr.vide r.liable communication,collabor.tion,and coor.ination in a multi-agency r.sponse system dur.ng dynamic and unexpected *** steps enable a constant connection between r.active contingency plans and the pr.activity in continuous r.sk assessment and enhance the flexibility of the contingency plans.

关键词： Disaster.r.sks Or.anizational changes Public health emer.encies Sweden

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Assessing Thai Hospitals’Evacuation Pr.par.dness Using the Flexible Sur.e Capacity Concept and Its Collabor.tive Tool

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Inter.ational Jour.al of Disaster.r.sk Science 2023年第1期14卷 52-63页

作者： Phatthr.nit Phatthar.por.jar.en Er.c Car.str.m Lina Dahlén Holmqvist Yuwar.s Sittichanbuncha Amir.Khor.am-manesh Institute of Clinical Sciences Department of SurgerySahlgrenska AcademyUniversity of Gothenburg40530GothenburgSweden Depar.ment of Emer.ency Medicine Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkok10400Thailand Institute of Health and Car. Sciences Sahlgrenska AcademyUniversity of Gothenburg40100GothenburgSweden Gothenbur. Emer.ency Medicine r.sear.h Gr.up Sahlgrenska AcademyUniversity of Gothenburg40530GothenburgSweden USN School of Business University of South-Eastern Norway3603KongsbergNorway Institute of Medicine Department of Internal Medicine and Clinical NutritionSahlgrenska University Hospital40530GothenburgSweden

Accor.ing to the concept of“flexible sur.e capacity,”hospitals may need to be evacuated on two occasions:(1)when they ar. exposed to danger.such as in war.and(2)when they ar. contaminated,such as dur.ng the Covid-19 *** the for.er.the entir. hospital must be evacuated,while in the latter.the hospital becomes a pandemic center.necessitating the tr.nsfer.of its non-contaminated staff,patients,and r.utine activities to other.*** occasions involve sever.l degr.es of evacuation—par.ial or.total—yet all r.quir. deliber.te sur.e planning and collabor.tion with diver.e *** study aimed to investigate the extent of hospital evacuation pr.par.dness in Thailand,using the main elements of the flexible sur.e capacity concept.A mixed method cr.ss-sectional study was conducted using a hospital evacuation questionnair. fr.m a pr.viously published multinational hospital evacuation *** tool contained questions r.gar.ing evacuation pr.par.dness encompassing sur.e capacity and collabor.tive elements and an open-ended inquir. to gr.sp potential *** 143 secondar. car.,ter.iar. car.,and univer.ity hospitals r.ceived the questionnair.;43 hospitals pr.vided *** findings indicate glitches in evacuation pr.tocols,par.icular.y tr.age systems,the inadequacies of sur.e planning and multiagency collabor.tion,and knowledge limitations in community *** conclusion,the applications of the essential components of flexible sur.e capacity allow the assessment of hospital pr.par.dness and facilitate the evaluation of guidelines and instr.ctions thr.ugh scenar.o-based tr.ining exer.ises.

关键词： Collabor.tive tool Disaster.pr.par.dness Flexible sur.e capacity Hospital evacuation Multiagency collabor.tion Thailand

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Disaster.Collabor.tive Exer.ises for.Healthcar. Teamwor. in a Saudi Context

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Inter.ational Jour.al of Disaster.r.sk Science 2023年第2期14卷 183-193页

作者： Mohammed Ali Salem Sultan Amir.Khor.am-manesh Jar.e Lφwe Sφr.nsen Johan Ber.in Er.c Car.str.m Model of Car. Healthcare TransformationRegional Health DirectorateNajran66255Saudi Arabia Institute of Health and Car. Sciences Sahlgrenska AcademyGothenburg University40530GothenburgSweden Institute of Clinical Sciences Sahlgrenska AcademyGothenburg University40530GothenburgSweden Gothenbur. Emer.ency Medicine r.sear.h Gr.up(GEMr.G) Sahlgrenska Academy41345GothenburgSweden USN School of Business University of South-Eastern Norway3199BorreNorway Depar.ment of Social and Behaviour.l Studies University West46186TrolhättanSweden

This study aimed to evaluate the development of healthcar. teamwor. dur.ng and after.the collabor.tion tabletop exer.ises,thr.ugh obser.ation and inter.iew *** and matur.ty theor.tical models wer. employed to explain the collabor.tive challenges in teams that may suffer.fr.m unequally distr.buted power.hier.r.hies,and *** thr.e-level collabor.tion tabletop exer.ises and the Command and contr.l,Safety,Communication,Assessment,Tr.atment,Tr.age,Tr.nspor.(CSCATTT)instr.ment,100 healthcar. wor.er. wer. obser.ed dur.ng each step in the implementation of the CSCATTT instr.ment using two simulated *** r.sults show a lack of integr.tion and team matur.ty among par.icipants in the fir.t scenar.o,leading to the delayed star. of the activity,task distr.bution,and decision *** shor.comings wer. impr.ved in the second ***-depth inter.iews with 20 par.icipants in the second phase of the study r.vealed impr.ved knowledge and pr.ctical skills,self-confidence,and ability in team building within tr.ns-pr.fessional gr.ups in the second scenar.o,which in concor.ance with the integr.tion theor.,was due to the attempts made in the fir.t ***,ther. was an impr.vement in the team’s matur.ty,which in concor.ance with the matur.ty theor.,was due to the knowledge and pr.ctical skills dur.ng scenar.o *** r.sults indicate the impor.ance of continuous tabletop tr.ining,and the use of CSCATTT as a collabor.tive instr.ment,to pr.mote the development of collabor.tion and to test the concept of pr.par.dness.

关键词： Collabor.tion exer.ises Disaster.education Emer.ency management Healthcar. per.onnel tr.ining Saudi Ar.bia Teamwor.

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